Brain Damage and Traumatic Brain Injury (TBI)

Generally, physicians consider four factors when diagnosing and evaluating the severity of a brain damage or a brain injury. Those factors are (1) biomechanical force, (2) acute symptoms, (3) neuropsychological deficits, and (4) a changed or different person.

Traumatic brain injuries come in many shapes and forms and have many names. Brain injuries are most often classified as mild, moderate and severe, based whether the injury to the brain is life-threatening, they can occur with and without a loss of consciousness, with and without (retrograde or anterograde) amnesia, and with and without a coma. The lasting effects of a brain injury also go by many names, including:

post-concussion syndrome;

traumatic head syndrome;

traumatic dephalgia;

post-brain injury syndrome;

post-traumatic syndrome; and

labrynthitis.

Some brain injuries are easily diagnosed. For example, a brain bleed or subdural hematoma can be observed on an x-ray, MRI or CT scan. However, an individual can suffer from a permanent and irreversible brain injury even though the results of all diagnostic imaging studies are "unremarkable," "negative," "normal," or "within normal limits." This is because modern day technology cannot capture injury to the brain on a cellular level, caused by one or a combination of the following forces:

Impact (e.g., blow to the head, striking the head on an object or the ground);

Acceleration (e.g., body moving forward so fast that brain strikes back of skull);

Contracoup (e.g., head motion that causes the brain to slosh around inside the skull); and

Shearing (e.g., movement that causes brain fibers called axons, which exist between brain layers, to shear or tear)

According to the American Congress of Rehabilitation Medicine, an individual may be suffering from a brain injury if they experience any of the following after a trauma or accident: (1) loss of consciousness, (2) loss of memory before or after the accident (retrograde or anterograde amnesia), (3) altered mental state, or (4) focal neurological deficits.

The injury is "mild" if the amnesia lasts no more than 24 hours, if the loss of consciousness lasts less than thirty (30) minutes, and if the Glasgow Coma Scale score in 13-15 within thirty (30) minutes of the incident/accident. Mild traumatic brain injury symptoms may not present or persist for days, weeks or months after a trauma or accident. Part of the complexity of a brain injury is that the symptoms present differently in each patient. They include cognitive, emotional, behavioral and physical symptoms.

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